J.Jpn. Surg. Soc.. 58(7): 1036-1052, 1957

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EXPERIMENTAL STUDIES ON THE PRODUCTION AND DISPOSAL OF INDOLE IN THE BODY DURING ILEUS

As a part of the investigation on the actions and effects of ileus in the body, the formation and disposal of indole during ileus have been studied under the supervision of Prof. Matsukura. The study included the determination of sulfuric acid content as related to the main problem. The results obtained are as follows:
I. (1) The presence of indole cannot be demonstrated in the blood of portal, hepatic or femoral vein for the first 8 hours after the establishment of ileus, but a small amount can be found after 12 hours. The formation of indican, on the contrary, can be shown to have increased to its maximum value within 8 hours, slightly decreasing thereafter. It is furthermore worthy of note that the increase in the amount of indican in the hepatic vein blood far exceeds that of the portal vein blood.
(2) A remarkable increase of indole occurs in the contents of closed intestinal loop during ileus but indican shows hardly any increase.
(3) Indole can be demonstrated in a small amount in the peritoneal fluid within 8 hours after the esta blishment of ileus, but indican , just as in the blood, shows a great increase.
(4) Indole is totally absent in the urine, although indican is increased slightly.
II. In patients to whom streptomycin has been given orally before establishment of ileus, indole cannot be demonstrated, and indican continues to maintain a low level throughout the entire course.
The above facts are not only in good agreement with Prof. Matsukura's report that indole producing bacteria multiply within the closed loop of the intestine during ileus, but the administration of streptomycin changes these into non-indole producing organisms, thus significantly prolonging the survival time of ileus animals, but can be considered to show that the indole formation in the body during ileus is due to the activity of the indole-producing organisms in the closed loop of the intestine.
III. The liver and intestinal wall are normally very powerful in the disposition of indole, as the results of perfusion experiment show, but this ability is markedly impaired in the course of ileus. No such action, except that due to excretory function, can be seen in the kidneys. When these facts are taken into consideration in the interpretaion of experimental result as to the fluctuations in indole and indican formation, it is possible to infer that indole, which is formed in lagre amounts during ileus, is broken down by the liver and intestine during the early stage, but after 8 hours the decomposition becomes gradually retarded hence causing indican, a degradation product, to decrease, because of the migration of indole into the blood and peritoneal fluid.
IV. (1) The sulfuric acid content of serum increases slightly during the early stage of ileus, but gradually decreases after 8 hours. This is due mainly to the fluctuation of inorganic sulfate.
(2) Sulfuric acid in the urine shows high values in contrast with a slight increase in the serum, with approximately a similar course. This is caused chiefly by the change in ethereal sulfates.
(3) The sulfuric acid content of the liver and intestine shows a slight decrease during the course of ileus, due to the decrease in inorganic sulfate.
(4) The sulfuric acid content of the kidney exhibits variations comparable to those of the serum, depending on the changes in both ethereal and inorganic sulfates.
(author's abstract)

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